Rep. Robbins Comments on DHS’ Revalidation of High-Risk Medicaid Providers 

ST. PAUL – The Minnesota Department of Human Services (DHS) released the results of its revalidation of service providers in the 13 high-risk Medicaid programs.  This revalidation was required by the federal Centers for Medicare and Medicaid Services (CMS) to ensure program integrity in the wake of the staggering fraud in Minnesota’s Medicaid programs.

The revalidation of providers had to be completed by May 31, 2026, to restore federal confidence in Minnesota’s programs and forestall a pending cut of $2 billion in federal Medicaid funds due to Minnesota’s catastrophic management failures in these programs, which are intended to serve our most vulnerable citizens. Revalidation included providing documentation on ownership, licensure and staffing, finger-print background studies for owners and an on-site visit.

Of the 5,583 high-risk providers reviewed by DHS, only 37% (2,061) were revalidated and allowed to continue providing services.

61% of providers (3,411) were disenrolled. 2,491 providers were disenrolled due to incomplete or inaccurate data; 916 failed site visits; and 4 failed the ownership background study. An additional 2% of providers (111) were disenrolled because they had already stopped providing services.

“These numbers are astonishing and problematic,” stated Kristin Robbins, Chair of the House Fraud Prevention & State Agency Oversight Committee. “More than 63% of the providers were disenrolled from the 13 high-risk programs, which shows the complete failure of management and internal controls that has been going on for years. Only 37% were allowed to continue to provide services. Since DHS had not reported getting widespread complaints from recipients about providers, it will be important to see how much of that 63% was fraudulent.”

“I have a number of questions for DHS, based on this brief snapshot of the revalidation data,” Robbins continued. “Of the 111 who were no longer providing services, were any still billing Medicaid? Of the 916 that failed the site visit, how many were actually operating? Of the 59 referred to the Inspector General, were they all referred for fraud? And of the 4 who failed the background check, what was the reason? Had any of them been indicted or convicted of fraud?”

“I look forward to getting answers from DHS.  Someone must be held accountable for these failures,” said Robbins. “I am grateful Dr. Oz and his team at CMS have come in here to restore integrity in our Medicaid programs. Without this revalidation requirement by CMS, we would still be shoveling millions of taxpayer dollars out the door without knowing if providers were qualified or actually providing services being billed for.”